Glycaemic management of type 2 diabetes

The United Kingdom Prospective Diabetes Study was a landmark, clearly demonstrating that intensive glycaemic management of type 2 diabetes significantly reduced both microvascular and macrovascular complications (Figure 1). National targets aim for an HbA1c level of less than 6.5% in those with type 2 diabetes who are at risk of cardiovascular disease. Since the 1920s, when insulin was discovered, there has never been a more exciting time to work in the field of diabetes. In the UK, the National Service Framework and General Medical Services contract for general practitioners has moved diabetes up the health-care agenda.3 Although diet and lifestyle interventions remain pivotal to the management of this chronic condition, the importance of structured patient education and self-management is increasingly recognized.